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  • The European Summit for Clinical Nanomedicine 2012 (5th CLINAM 2012)

    Basel, Switzerland, May 7-9, 2012




      REGISTRATION FORM

  • Attendee identification

    • *
    • *Last name
    • *First name
    • *Category
    • *Profession
    • *Company / University
    • *Department / Affiliation
    • *Address
    • *Zip code
    • *City
    • *Country
    • *Phone
    • Fax
    • Mobile
    • *Email
    • I hereby accept that my family name, first name, function and organization may be mentionned on the attendees list which will be given during the congress.
    *Compulsory fields

  • Fees informations

    Full ticket (7-9 May 2012)
    Registration Early until 15 Jan.12 Regular as from 16 Jan.12 Late After 12 Apr. 12
    Academy member 530 € 590 € 660 €
    Academy regular 685 € 760 € 830 €
    Government / International agency member 630 € 770 € 840 €
    Government / International agency regular 700 € 870 € 940 €
    Industry member 830 € 920 € 990 €
    Industry regular 965 € 1 150 € 1 220 €
    Student member 350 € 400 € 430 €
    Student regular 450 € 500 € 530 €
    Fees include: 3 days conference access, coffee breaks, lunches and congress bag.

    One day ticket
    Registration 1 Day 1 Day Late After 12 Apr. 12
    Academy member 240 € 280 €
    Academy regular 310 € 350 €
    Government / International agency member 310 € 350 €
    Government / International agency regular 410 € 450 €
    Industry member 390 € 430 €
    Industry regular 460 € 500 €
    Student member 145 € 165 €
    Student regular 200 € 220 €
    Fees include: 1 day conference access, coffee breaks, lunch and congress bag.

  • Fees selection

    Full ticket
    One day ticket
  • Please choose day :
    Monday 7 May, 2012
    Tuesday 8 May, 2012
    Wednesday 9 May, 2012

  • Social Event

    If you wish to attend to the gala dinner, please register here below:
    Evening Event on Monday May 7, 2012 50,00 € TTC

  • Cancellation policy

    Before April 5, 2012 No penalty
    From April 6 until 21, 2012         50% fees are due
    After April 21, 2012 100% fees are due
    The dates refer to receipt of the cancellation. Please notice that substitutions of participants can be made any time.
    Cancellation requests must be sent to Insight Outside either by fax or by email.

  • For further information

    Registration Organization
    INSIGHT OUTSIDE
    39 chemin du vieux chêne - 38240 Meylan
    Tel: +33 825 595 525 (0,15€/min*) - Fax: +33 4 38 38 18 19
    Email: clinam2012@insight-outside.fr
    Web site: http://www.insight-outside.fr

    Information desk
    monday to friday from 2:00pm to 5:00pm         		CLINAM
    Alemannengasse 12
    P.O. Box
    CH-4016 Basel
    Contact: Beat LOEFFLER
    Email: loeffler@clinam.org
    Phone: 00 41 61 695 93 95
    (*) Prices starting from fixed line incumbent, a surcharge may be applied by operators, counting the second after the first 45 seconds.

    According to France's Personal Data Privacy Act in effect since June 2004, you may send a request in writing to INSIGHT OUTSIDE 39 chemin du vieux chêne, 38240 Meylan / France, or by email webmaster@insight-outside.fr to access your file in order to consult, modify and/or delete your personal information.

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